ArticleCirculation2024
Association of Urinary Metals With Cardiovascular Disease Incidence and All-Cause Mortality in the Multi-Ethnic Study of Atherosclerosis (MESA).
Article in Circulation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.
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Who cites it
34 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Metallomic Dysregulation and Cardiovascular Disease: Essential Trace Elements, Non-essential Metal Exposure, and Heart Failure Risk: A Systematic Review.Cardiovascular toxicology · 2026Pooled it
- "Low-to-moderate arsenic exposure: a global systematic review of cardiovascular disease risks".Environmental health : a global access science source · 2025Pooled it
- Climate-amplified wildland-urban interface disasters create persistent internal metal mixtures associated with pulmonary impairment.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Combined Effects and Potential Mechanisms of Multiple Metals Exposure on Coronary Artery Disease in the US Population: An Integrated Epidemiological and Network Toxicology Study.Biological trace element research · 2026Article
- Associations of blood and urinary heavy metals with obesity risk among children: NHANES 2015-2020.Pediatric research · 2026Article
- Metal and metal mixture biomarkers across three U.S. cohorts: MASALA, MESA-LA, and Strong Heart Family Study.Journal of exposure science & environmental epidemiology · 2026Article
- Streetview greenspace types and dementia risk in older adults: the Multi-Ethnic Study of Atherosclerosis.American journal of epidemiology · 2026Article
- Article
- Integrating Environmental Exposure Profiles with Temporal Transcriptomics: An Explainable Machine Learning Model for Cardiovascular Disease Risk Prediction and Biological Validation.Cardiovascular drugs and therapy · 2026Article
- Associations Between Welding-Related Metals and Atherosclerotic Cardiovascular Disease Risk in Male Welders: The Mediating Role of Accelerated Biological Aging.Cardiovascular toxicology · 2026Article
- The environmental exposome in heart failure risk and progression.Nature reviews. Cardiology · 2026Review
- Street view-based exposure to greenspace and mortality: the Multi-Ethnic Study of Atherosclerosis.Environment international · 2026Article
- Circulating multiple metals and mortality after myocardial infarction: incremental value beyond GRACE.American journal of preventive cardiology · 2026Article
- Sex-Specific Associations Between Cadmium Exposure and Mortality Risk in Cardiovascular Disease Patients: A Cohort Study Integrating Molecular Mechanisms of Myocardial Dysfunction.Cardiovascular toxicology · 2026Article
- Sustained cadmium exposure and hyperglycemia additively drives mitochondrial dysfunction in hepatic cells: Implications for MASLD etiopathogenesis.Toxicology and applied pharmacology · 2026Article
- The role of coronary artery calcification in metal-related cardiovascular disease.Environment international · 2026Article
- Evaluation of Polystyrene Nanoplastics Induced Cardiotoxicity Under Different Dietary Patterns in Mice.Toxics · 2025Article
- Serum 25‑hydroxyvitamin D and dietary calcium intake interact in relation to blood cadmium in pregnant women: evidence from the NHANES survey.BMC pregnancy and childbirth · 2025Article
- Associations Between Blood Heavy Metal Concentrations and Hypertensive Disorders of Pregnancy in the Japan Environment and Children's Study.Journal of the American Heart Association · 2025Article
- The predictive value of multiple urinary metals in evaluating death risk in asthmatic individuals: a prospective cohort study.Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine · 2025Article
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19 authors.
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Abstract
backgroundExposure to metals has been associated with cardiovascular disease (CVD) end points and mortality, yet prospective evidence is limited beyond arsenic, cadmium, and lead. In this study, we assessed the prospective association of urinary metals with incident CVD and all-cause mortality in a racially diverse population of US adults from MESA (the Multi-Ethnic Study of Atherosclerosis).
methodsWe included 6599 participants (mean [SD] age, 62.1 [10.2] years; 53% female) with urinary metals available at baseline (2000 to 2001) and followed through December 2019. We used Cox proportional hazards models to estimate the adjusted hazard ratio and 95% CI of CVD and all-cause mortality by baseline urinary levels of cadmium, tungsten, and uranium (nonessential metals), and cobalt, copper, and zinc (essential metals). The joint association of the 6 metals as a mixture and the corresponding 10-year survival probability was calculated using Cox Elastic-Net.
resultsDuring follow-up, 1162 participants developed CVD, and 1844 participants died. In models adjusted by behavioral and clinical indicators, the hazard ratios (95% CI) for incident CVD and all-cause mortality comparing the highest with the lowest quartile were, respectively: 1.25 (1.03, 1.53) and 1.68 (1.43, 1.96) for cadmium; 1.20 (1.01, 1.42) and 1.16 (1.01, 1.33) for tungsten; 1.32 (1.08, 1.62) and 1.32 (1.12, 1.56) for uranium; 1.24 (1.03, 1.48) and 1.37 (1.19, 1.58) for cobalt; 1.42 (1.18, 1.70) and 1.50 (1.29, 1.74) for copper; and 1.21 (1.01, 1.45) and 1.38 (1.20, 1.59) for zinc. A positive linear dose-response was identified for cadmium and copper with both end points. The adjusted hazard ratios (95% CI) for an interquartile range (IQR) increase in the mixture of these 6 urinary metals and the corresponding 10-year survival probability difference (95% CI) were 1.29 (1.11, 1.56) and -1.1% (-2.0, -0.05) for incident CVD and 1.66 (1.47, 1.91) and -2.0% (-2.6, -1.5) for all-cause mortality.
conclusionsThis epidemiological study in US adults indicates that urinary metal levels are associated with increased CVD risk and mortality. These findings can inform the development of novel preventive strategies to improve cardiovascular health.
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